World Neurosurg
-
Comparative Study
Single center experience of Mechanical thrombectomy with the Trevo XP ProVue 6×25 mm stent retriever in MCA occlusion : Comparison with Trevo XP ProVue 4×20 mm.
There are few studies assessing the suitable stent size for mechanical thrombectomy in middle cerebral artery (MCA) occlusion. We attempted to determine what size of stent is suitable for thrombectomy in MCA occlusion through a comparison of Trevo XP 6 × 25 mm and 4 × 20 mm stents. ⋯ Our study showed that the Trevo XP 6 × 25 mm stent provides better clinical and radiologic outcomes than the Trevo XP 4 × 20 mm stent for MCA occlusion without an increase in the rate of complications.
-
Comparative Study
Hybrid Bone SPECT/CT imaging in evaluation of chronic low back pain.Correlation with facet joints arthropathy.
Evidence to support the use of bone hydroxydiphosphonate (HDP) single photon emission computed tomography (SPECT/CT) in patients with facetogenic low back pain (LBP) is still limited. In this study we compared the scintigraphic patterns on bone SPECT/CT with the degree of structural facet joint (FJ) degeneration on CT in patients with LBP. ⋯ The ability of SPECT/CT to precisely localize scintigraphically active FJs may provide significant improvement in the diagnosis and treatment of patients with LBP. In this study we demonstrate that in >40% of FJs, the scintigraphic patterns on SPECT/CT did not correlate with the degree of degeneration on CT.
-
Observational Study
Association of perforator infarction with clinical courses and outcomes following surgical clipping of ruptured anterior communicating artery aneurysms.
Perforator infarction is a procedure-related complication of surgical clipping of ruptured anterior communicating artery (ACoA) aneurysms. Patients with perforator infarction may present with specific clinical features. The aim of this study was to elucidate incidence, risk factors, clinical course, and outcomes of perforator infarction following surgical clipping of ruptured ACoA aneurysms. ⋯ Perforator infarction following surgical clipping of ruptured ACoA aneurysms caused region-specific complications, including hyponatremia and insufficient oral intake, and was associated with poor functional outcomes.
-
Tubular microdiscectomy has become a staple technique among spine surgeons. Yet the associated learning curve, especially its later stages, has not been extensively studied. With studies reporting a higher rate of recurrent herniation using tubular microdiscectomy, surgeons' level of experience becomes of primary importance for the interpretation of such findings. We aimed to analyze possible improvements in the later stages of the learning curve and to identify factors independently associated with recurrent herniation. ⋯ Relevant improvements in clinical results were seen even after the surgeon had already accumulated extensive experience. Any future studies should unambiguously report the level of experience of the participating surgeons, possibly including the number of cases previously treated using a particular technique.
-
Case Reports
Surgical treatment of cavernous malformations involving the midbrain:a single center case series of 34 patients.
Cavernous malformations (CMs) involving the midbrain are more challenging for surgical treatment than are CMs at other sites because of the surrounding critical structures and deep location. However, specific features and treatment strategies have not been well illustrated. ⋯ Although surgery for MBCMs is associated with significant perioperative morbidity and mortality, most patients show favorable outcomes. Higher preoperative mRS score is an independent predictor of poor functional outcome.